I would not have hesitated to call a vegetative person dead, two weeks ago.

I thought the brain was what keeps the heart and lungs working, and that if the brain stops sending signals then the other two won't work anymore even if we hook them up to a machine.

This little girl has been breathing and has her heart beating for more than four years after being declared dead.

I love that the article mentioned the brain dead definition is usually decided on by intellectuals who would see themselves as dead when they are no longer able to use their intellect to converse and interact with the world.

It's an attitude that ignores a passively "hanging out" family member who might just want to hear what's going on, even if they can't interact back. It's like someone quiet at your table: if they are not talking, does that mean they aren't part of the party?

I was so confident in my answer until two weeks ago, when my mother had a stroke. I used to think death is this perfectly precise fine line that divides 1 from 0, until my loved ones fell into that band and didn't come out of either side. She lived in that land where by some definition she's one but by some she's another.

I hope she experiences a healing miracle. It would turn our world completely upside-down, but it would help us talk about dignity of life beyond terms like if someone can contribute to commerce, offer fresh organs, or intelligence defines life.

It's an attitude that ignores a passively "hanging out" family member who might just want to hear what's going on, even if they can't interact back. It's like someone quiet at your table: if they are not talking, does that mean they aren't part of the party?

I do kind of disagree with you. There is more than enough debate around death that it cannot be a simple binary state. My experience with loved ones, brain cancer and euthanasia, however, made it clear to me that it's consciousness that matters, not intellect or interaction. The slow decline of the brain resulted in less and less intellect, then less and less interaction, and finally consciousness fading away as well. There was no single point where it was clear that she went from 1 to 0, but at some point you know that the brain, and her consciousness, was irreversibly broken, despite her heart beating on and her lungs working. It's that irreversibility that I find most important - if she will never be conscious again, she will never be alive again, never care or love again, never interact again. There could still be spasms or deep-rooted physical responses like in the article, but what does that matter when there's no mind to witness it?

I think I understand what you are saying and, although my current thoughts are a mess, would have readily agreed with you two weeks ago.

The gray area comes from when exactly 1 should be transitioned to 0. If someone no longer has intellect but has consciousness, it's pretty hard to unhook machines that will gaurantee the transfer to death. If someone has almost no consciousness but to the family seems like they do some of the time, that can be an uncomfortably long time.

This little girl will never laugh or walk again, her family knows that. And it sounds like to them they are, in their minds, ready to let go when she is no longer responding: ie, no more consciousness. The trouble is what seems like non consciousness spasms to some looks an awful lot like periodic consciousness to others.

I don't think we're comfortable reclassifying death as "unable to demonstrate consciousness after X months" or "can't obey requests after x minutes". The article shows some aren't comfortable with defining death as lack of MRI evidence for brain activity. So what should it be? When x percentage of the brain becomes liquified?